Pathology Trends
Pathology groups face a number of challenging pathology trends in the era of radical healthcare reform.
One of the primary trends is that like clinical laboratories, these businesses are carrying significant and potentially unsustainable levels of unreimbursed services. Although bad debt and uncompensated care in the healthcare industry are not new, they have been increasing at the same time that downward pressure is being applied to pathology reimbursement.
Medical laboratories and pathology groups are also facing enormous levels of change in their clinical, regulatory and financial environments. As the Affordable Care Act is implemented, laboratories see downward pressure on reimbursement at both the federal and payer level, coupled with increased emphasis on efficiency and quality.
Labs and health care providers need to seriously consider moving toward a retail business model. Changes in the health insurance market are now requiring patients to pay more out of pocket, and the perfect storm of bad debt and decreased requirement is pressuring laboratories.
Other pathology trends include:
- Growing emphasis on the continuum of care
- Increasing patient interaction directly with the lab organization
- Mounting demands of interoperability across a proliferation of disparate information technology systems to achieve meaningful use
- Evolving requirements for communication and data sharing with payers, accountable care organizations (ACOs), health information exchanges (HIEs) and other trading partners
Industry observers say that responding to each of these trends requires access to the most complete set of patient data possible. Accurate patient identification and record consolidation is central to achieving these goals.
In addition, labs and pathologists are increasingly urged to add value to the testing services they perform by leveraging information technology. For instance, advanced health information technology can be deployed within clinical labs and pathology groups specifically to meet changing patient expectations, while supporting the needs of client physicians for optimal workflow.
Details Emerge in KU Hospital Misdiagnosis by Pathology Chair
AFTER A PATIENT FILED A LAWSUIT against a pathologist at the University of Kansas Hospital for fraud and negligence in a case stemming from a misdiagnosis of cancer in 2015, details about a settlement in the case were sealed. Now, some details have come out. Last month, NPR statio…
Anthem’s Cuts in AP Fees Could Put Patients at Risk
CEO SUMMARY: Consultants who work with anatomic pathologists have several theories about why Anthem is enacting deep cuts of 50% to 70% for the professional component of many anatomic pathology services. While they have different ideas about what motivates the nation’s second largest he…
Few Options for Pathology Groups Facing Anthem’s Payment Cuts
FACED WITH DEEP CUTS in payment for anatomic pathology professional component services from Anthem Inc., pathologist have only a few options in how they can respond, according to consultants who work with AP groups. “These are dire cuts to anatomic pathology reimbursement,” said…
Arkansas Pathologist Faces 3 Manslaughter Charges
CEO SUMMARY: Federal prosecutors in Arkansas charged a former Veterans Administration pathologist with three counts of involuntary manslaughter and 28 other criminal counts related to his work at the Veterans Health Care System of the Ozarks. In the indictment, officials charged that the …
Is Pathology Workforce Stable or Shrinking?
CEO SUMMARY: After publishing research in JAMA Network Open showing a coming shortage of pathologists in the United States, the researchers heard from pathologists whose experience in the job market did not match what the researchers found. Anecdotal evidence indicates that the demand for…
JAMA Study: 17% Fewer Pathologists Since 2007
CEO SUMMARY: The number of pathologists working in the United States declined by 17.53% from 2007 to 2017, according to recent research published in the Journal of the American Medical Association. When adjusted for the U.S. population, the researchers said the workforce of pathologists i…
Fewer Pathologists Means Tighter Market for Jobs
CEO SUMMARY: Pathologists seeking jobs will find that a more competitive job market is pushing salaries up over $300,000 per year on average. In addition, most new jobs come with a hiring bonus and funds for relocation of as much as $12,000 and for continuing medical education of $3,500. …
Dr. Papanicolaou Honored by Google Doodle on May 13
Pathologists and medical laboratory professionals the world over had a surprise on May 13 if they used Google for an Internet search. The doodle on the Google search home page honored pathologist Dr. Georgios Papanicolaou, who developed the Pap smear test used to screen for cervical …
Patient Care Focus Helps Path Group Win Contract
CEO SUMMARY: When Ascension Wisconsin wanted one pathology group to serve its needs statewide, North Shore Pathologists responded to the request for proposal by focusing on how pathologists can improve patient care through a patient-centered model. Other pathology groups responded with pr…
UK’s NHS to Build Five New Digital Path and Imaging Centers
TO SHORTEN THE TIME FOR CANCER DIAGNOSES, the United Kingdom’s National Health Service (NHS) will open five new digital pathology and imaging centers that will use artificial intelligence. The digital pathology and imaging centers will open in Coventry, Glasgow, Leeds, London, and Ox…
CURRENT ISSUE
Volume XXVII, Number 16 – November 16, 2020
UNWELCOME CHANGES to how labs do business are forcing labs to cope with high demand for COVID-19 testing while dealing with government and private payers interfering with normal operating procedures. Medicare has new requirements and payment rates for COVID-19 tests. Also reported here are UnitedHealthcare’s new Laboratory Test Registry Protocol, and California’s new COVID-19 testing laboratory that is diverting lab instruments, supplies, and test kits away from hospital and independent labs in the state.
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